Minority Health and Health Disparities: Definitions and Parameters

Definitions of the terms “minority health” and “health disparities” have evolved as the research fields have grown and interacted with the full spectrum of scientists. Initially, the definitions were intertwined, as the researchers doing this important work have bridged both fields, and the assumption was made that minority populations always had health disparities. For NIH, this plan underscores the need to separate the science of minority health, which focuses on the health of racial and ethnic minority communities, and the science of health disparities, which focuses on differences in health outcomes for defined disadvantaged populations that are worse than the White reference population. There is clear overlap, since for many conditions, minority populations have well-defined health disparities compared with the White population in the United States. However, creating some separation of these disciplines may prove beneficial in enabling each field to make greater independent strides. Over the course of fiscal years (FYs) 2015 and 2016, NIMHD undertook a process across NIH to revise the definitions for minority health and health disparities.1

Minority Health Definition

Minority health (MH) refers to the distinctive health characteristics and attributes of racial and/or ethnic minority groups, as defined by the U.S. Office of Management and Budget (OMB), that can be socially disadvantaged due in part to being subject to potential discriminatory acts.

Minority Health Populations

NIH uses the racial and ethnic group classifications determined by OMB in the Revisions to Directive 15, titled Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity. The minority racial and ethnic groups defined by OMB are American Indian or Alaska Native, Asian, Black or African American, and Native Hawaiian or other Pacific Islander. The ethnicity used is Latino or Hispanic.

Although these five categories are minimally required, the mixed or multiple race category should be considered in analyses and reporting, when available.

Other NIH efforts that support Tribal Nations can be found in the NIH Strategic Plan for Tribal Health Research FY 2019-2023. (PDF 1.1 MB)

Self-identification is the preferred means of obtaining race and ethnic identity.

Minority Health Research

Minority health research is the scientific investigation of distinctive health characteristics and attributes of minority racial and/or ethnic groups who are usually underrepresented in biomedical research to understand health outcomes in these populations.

Health Disparity Definition

A health disparity (HD) is a health difference that adversely affects disadvantaged populations, based on one or more of the following health outcomes:

  • Higher incidence and/or prevalence and earlier onset of disease
  • Higher prevalence of risk factors, unhealthy behaviors, or clinical measures in the causal pathway of a disease outcome
  • Higher rates of condition-specific symptoms, reduced global daily functioning, or self-reported health-related quality of life using standardized measures
  • Premature and/or excessive mortality from diseases where population rates differ
  • Greater global burden of disease using a standardized metric

Health Disparity Populations

NIH defines health disparity populations as racial and ethnic minority populations (see above OMB directive), less privileged socioeconomic status (SES) populations, underserved rural populations, sexual and gender minorities (SGM), and any subpopulations that can be characterized by two or more of these descriptions.

Other NIH efforts that support SGMs can be found in the NIH FY 2016-2020 Strategic Plan to Advance Research on the Health and Well-being of Sexual and Gender Minorities. (PDF 2.3 MB)

Health Determinants

There are many factors that impact an individual’s health and the risk of experiencing health disparities. These domains of influence have been expanded into “health determinants” in order to capture areas that go beyond the social determinants and that include factors, such as individual behaviors, lifestyles, and social responses to stress; biological processes, genetics, and epigenetics; the physical environment; the sociocultural environment; social determinants; and clinical events and interactions with the health care and other systems. Each of these health determinants plays an important role in health disparities and interacts in complex ways to impact an individual’s health. For example, African American/Black women and Latinas experience lower survival rates from triple-negative breast cancer than White women with the same disease-even with similar access to care, screening mammography, and insurance coverage-due to the lack of specialized screening and lack of viable treatment options available for this form of breast cancer.2



References

  1. AJPH Supplement: New Perspectives to Advance Minority Health and Health Disparities Research. Am J Public Health. 2019;109(S1).
  2. Heckler MM. Ko NY, Hong S, Winn RA, Calip GS. Association of Insurance Status and Racial Disparities With the Detection of Early-Stage Breast Cancer. JAMA Oncol. 2020;6(3):385-392.

Page updated March 31, 2021